Medicaid Expansion would Benefit Nebraska

Americans are evenly divided in supporting or opposing the Affordable Care Act (ACA). Nonetheless, it’s here to stay. Some provisions of the law have been implemented, but many more await us (view an implementation timeline at http://www.healthcare.gov/law/timeline/index.html).

One such provision allows states to cover individuals with incomes up to 138% of the federal poverty – $15,415 for a one person household and $31,809 for a family of four – by expanding Medicaid.

Medicaid currently provides coverage for 36.5% of children, 29.3% of all pregnancies and 52.9% of nursing home residents in Nebraska. By expanding Medicaid nearly 100,000 additional low-income Nebraskans would qualify. A recent University of Nebraska Medical Center (UNMC) study found a record high number of uninsured Nebraskans under 65. Expanding Medicaid would cover many of Nebraska’s 217,000 uninsured.

Governor Heineman says Nebraska cannot afford the Medicaid expansion. I would argue that we cannot afford to NOT participate. The average insured Nebraska family pays a “hidden tax” of $1,107 to pay for health care for the uninsured. According to another UNMC report, without Medicaid expansion, uncompensated care for the uninsured would cost $1.069 billion dollars. However, that cost would decline to $419 million dollars (a 61% decrease) with the expansion.

Nebraska would also receive federal funds of $2.9 billion to $3.5 billion through 2020, which could generate from $700 million to $840 million in new economic activity every year, not to mention 10,770 to 13,044 new Nebraska jobs.

So… should Nebraska expand Medicaid? The answer seems obvious to me.

Amanda McKinney, MD, is a physician at the Women's Health Center of Beatrice.